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Organization

SAINT MEDICAL GROUP, LLC

Active
Parent organization
SSM HEALTH CARE OF OKLAHOMA, INC.
Other names
SSM Health Behavioral Health Outpatient Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
SSM HEALTH CARE OF OKLAHOMA, INC.
Authorized official
CRYSTAL L PENA (PROVIDER ENROLLMENT)
(405) 272-7452
Entity
Organization

Contact information

Practice address
1031 N LEE AVE, OKLAHOMA CITY, OK 73102-1036
(405) 772-4699
Mailing address
1031 N LEE AVE, OKLAHOMA CITY, OK 73102-1036

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2084P0804X
Child & Adolescent Psychiatry Physician
2084P0805X
Geriatric Psychiatry Physician

Other

Enumeration date
07/29/2021
Last updated
07/29/2021
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